Individual provider Active NPI

Peter M Hwang, DDS

  • Dentist
  • New York, NY
National Provider Identifier
1366585671
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
048069 Issued in NY
Practice address
133 Morningside Ave
New York, NY 10027-4802
Phone
(212) 923-2525
Fax
(646) 981-9457
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 048069 NY Primary

Addresses

Primary practice location

133 Morningside Ave
New York, NY 10027-4802

Mailing address

188 Fairview Ave
Englewood Cliffs, NJ 07632-2016
Phone (917) 699-9147

Other practice location 1

455 River Rd
New Milford, NJ 07646-1933
Phone (917) 699-9147

Other identifiers 1

IdentifierTypeStateIssuer
01421705MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
048069NYMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1366585671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 FAIRVIEW AVE",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322016",
            "telephone_number": "917-699-9147",
            "fax_number": "201-346-9206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 MORNINGSIDE AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274802",
            "telephone_number": "212-923-2525",
            "fax_number": "646-981-9457"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 River Rd",
            "address_purpose": "LOCATION",
            "city": "New Milford",
            "state": "NJ",
            "postal_code": "076461933",
            "country_code": "US",
            "telephone_number": "917-699-9147",
            "fax_number": "201-346-9206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HWANG",
        "first_name": "PETER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "048069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01421705",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.